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In this video tutorial, the presenter demonstrates how to complete a HICFA 1500 claim form, used by non-institutional healthcare providers to submit claims. The focus is on filling out the form for a patient named Edna. The tutorial details selecting "other" in box one for commercial insurance, entering the member ID in box two, and providing the patient's name, date of birth, and gender in box three. Box five is for the patient's address and phone number, while box six indicates the patient relationship, which is "self" in this case. The presenter notes that if there were a guarantor or different policyholder, their information would be included instead. Lastly, the video addresses the insurance plan name in box E and mentions the possibility of another health benefit plan.
